Category: Medicaid

  • What to Watch in Medicaid Section 1115 Waivers One Year into the Biden Administration

    Section 1115 demonstration waivers provide states an avenue to test new approaches in Medicaid and generally reflect changing priorities from one presidential administration to another. This issue brief summarizes waiver priorities and actions under the Biden Administration as well as pending waiver themes and other issues to watch. If the Build Back Better Act (BBBA) […]

  • The Intersection of Medicaid, Special Education Service Delivery, and the COVID-19 Pandemic

    The COVID-19 pandemic created unprecedented health and education challenges for children with disabilities, many of whom receive special education services. Many children receiving special education services have substantial health care needs, and services available through a child’s health insurance plan, such as Medicaid, can complement special education services. This brief explains how Medicaid and special […]

  • Medicaid and At-Home COVID-19 Tests

    As COVID cases have surged across the United States due to the new Omicron variant, the Biden Administration has stepped up efforts to expand testing capacity including by making at-home COVID tests more available.

  • CMS Solidifies Vaccination Deadlines, Releases Guidance for Home Health Agencies

    The U.S. Supreme Court on Thursday threw its support behind the nationwide COVID-19 vaccine mandate for health care workers, while simultaneously axing a vaccine-or-test rule for large employers. Last week’s developments shouldn’t shock the in-home care operators that have been following the U.S. Centers for Medicare & Medicaid Services (CMS) and Occupational Safety and Health […]

  • Medicaid: What to Watch in 2022

    As 2022 kicks off, a number of issues are at play that could affect coverage and financing under Medicaid. This issue brief examines key issues to watch in Medicaid in the year ahead.

  • [Updated] Supreme Court Blocks OSHA Mandate, Allows CMS Rule to Take Effect

    The long-awaited decisions regarding the Biden administration’s vaccine mandates have finally arrived from the U.S. Supreme Court. In the end, the Occupational Safety and Health Administration (OSHA) “soft” mandate was shot down by SCOTUS by a 6-3 count. The mandate would have applied to all private businesses with 100 employees or more, requiring workers to […]

  • Left Behind: Medicaid Patients Say Rides to Doctors Don’t Always Come

    Tranisha Rockmore and her daughter Karisma waited at an Atlanta children’s hospital in July for their ride home. Karisma had been at Children’s Healthcare of Atlanta to have her gastrostomy tube fixed, Rockmore said. The 4-year-old, who has several severe medical conditions, has insurance coverage from Medicaid, which provides transportation to and from nonemergency medical […]

  • Clinics Say California’s New Medicaid Drug Program Will Force Them to Cut Services

    SACRAMENTO, Calif. — California’s sweeping new program to buy prescription drugs for its nearly 14 million Medicaid patients has alarmed health clinics that say they will lose money and have to cut services. Gov. Gavin Newsom acknowledged Monday that some clinics, which serve the poorest Californians, would lose funding, and he included $105 million for […]

  • Analysis of Recent National Trends in Medicaid and CHIP Enrollment

    This data note looks at national and state-by-state Medicaid and CHIP enrollment data through June 2021, as the COVID-19 vaccine became widely available to children and adults ages 12 and older and the number of COVID-19 cases and deaths were nearing a low point in 2022. Total Medicaid/CHIP enrollment grew to 83.2 million in June […]

  • South Dakota Voters to Decide Medicaid Expansion

    South Dakota voters will decide in November whether the state should become the 39th to expand Medicaid under the Affordable Care Act, a move that would provide coverage to 42,000 low-income residents. State officials on Monday officially placed the issue on the ballot after validating thousands of petition signatures. For nearly a decade, the Republican […]

  • CMS Releases Vaccine Mandate Guidance for Home Health Providers

    The U.S. Centers for Medicare & Medicaid Services (CMS) released guidance on evaluating providers’ compliance with the federal COVID-19 vaccination mandate for health care workers. Although CMS originally published the interim final rule in November, it posted the guidance for state survey agency directors on Tuesday. Broadly, the guidance applies to providers working under the […]

  • Nursing Homes Bleed Staff as Amazon Lures Low-Wage Workers With Prime Packages

    ERLANGER, Ky. — The sleek corporate offices of one of Amazon’s air freight contractors looms over Villaspring of Erlanger, a stately nursing home perched on a hillside in this Cincinnati suburb. Amazon Prime Air cargo planes departing from a recently opened Amazon Air Hub roar overhead. Its Prime semi-trucks speed along the highway, rumbling the […]

  • State Policies Connecting Justice-Involved Populations to Medicaid Coverage and Care

    The COVID-19 pandemic has magnified pre-existing health disparities for justice-involved populations, with coronavirus infection rates among incarcerated populations higher than overall infection rates in nearly all states. Justice-involved individuals are disproportionately low-income and often have complex and/or chronic conditions, including behavioral health needs. Although the statutory inmate exclusion policy prohibits Medicaid from covering services provided […]

  • Community Health Centers in the U.S. Territories and the Freely Associated States

    The U.S territories and the Freely Associated States (FAS) have faced an array of longstanding fiscal and health challenges, made worse by recent natural disasters and the coronavirus pandemic. Community health centers are an important part of health care system in the territories and FAS, providing access to a range of primary care services to […]

  • After ‘Truly Appalling’ Death Toll in Nursing Homes, California Rethinks Their Funding

    SACRAMENTO, Calif. — About 1 in 8 Californians who have died of covid lived in a nursing home. They were among the state’s most frail residents: nearly 9,400 mothers, fathers, grandparents, aunts and uncles whom Californians entrusted to a nursing home’s care. An additional 56,275 confirmed covid cases among nursing home residents weren’t fatal. “The […]

  • New Analysis of Historical Rates of Medicaid Enrollment Churn Sheds Light on the Implications for the End of the Continuous Enrollment Requirement Tied to Pandemic Funding

    For more than a year-and-a-half, the continuous enrollment requirement tied to enhanced Medicaid funding during the COVID-19 pandemic has all but halted enrollment “churn,” the temporary loss of coverage in which people disenroll from Medicaid and then re-enroll within a short period of time. Such disenrollments are expected to resume once the requirement ends and…More

  • Medicaid Enrollment Churn and Implications for Continuous Coverage Policies

    Recent policy actions and proposals in Medicaid have renewed focus on the problem of churn, or temporary loss of coverage in which enrollees disenroll and then re-enroll within a short period of time. We find that 10% of full-benefit enrollees have a gap in coverage of less than a year, and rates are higher for […]

  • A Rural Georgia Community Reels After Its Hospital Closes

    CUTHBERT, Ga. — Lacandie Gipson struggled to breathe. The 33-year-old woman with multiple health conditions was in respiratory distress and awaiting an ambulance. About 20 minutes after the emergency call, it arrived. The Cuthbert home where Gipson lived was less than a mile from Southwest Georgia Regional Medical Center, but the ambulance couldn’t take her […]

  • State Policies Expanding Access to Behavioral Health Care in Medicaid

    On KFF’s 21st annual Medicaid budget survey, all responding states reported at least one initiative to expand behavioral health care in Medicaid, including crisis service and other benefit expansions, initiatives to expand telehealth and address equity, and managed care changes.

  • Some Montana Nonprofit Hospitals Fall Short of Peers in Required Charitable Giving

    Montana’s richest nonprofit hospitals receive millions of dollars in tax exemptions each year to operate as charities, but some fall short of other medical facilities in what they give back to their communities to get those breaks. Overall, Montana’s nearly 50 nonprofit hospitals directed, on average, roughly 8% of their total annual expenses toward community […]

  • A Tale of Two Medicaid Expansions: Oklahoma Jumps In, While Missouri Lags

    Temp worker James Dickerson applied for Medicaid because it will be cheaper than his current health plan. Home health aide Sharon Coleman looks forward to having coverage that will cover a hospital stay. Incoming medical student Danielle Gaddis no longer worries a trip to the doctor will leave her in debt. All three are among […]

  • CMS Vaccine Mandate Blocked in 10 States

    First it was the COVID-19 vaccination mandate from the U.S. Occupational Safety and Health Administration (OSHA). Now, it’s the one from the Centers for Medicare & Medicaid Services (CMS). Since OSHA and CMS released their interim emergency regulations requiring COVID-19 vaccinations for certain individuals, each has been challenged in court. On Monday, a federal judge […]

  • CMS’s Strategic Vision for Medicaid And CHIP

    Where does the Centers for Medicare and Medicaid Services see Medicaid and the Children’s Health Insurance Program (CHIP) heading in the future. Based on a Health Affairs commentary from Brooks-LaSure and Tsai, the three key priority areas are (1) coverage and access, (2) equity, and (3) innovation and whole-person care. I review each of these […]

  • Build Back Better Would Reduce Disproportionate Share Hospital (DSH) Payments and Limit Uncompensated Care (UCC) Pools in Non-Expansion States

    The Build Back Better (BBB) Act proposes reducing disproportionate share hospital (DSH) allotments by 12.5% starting in federal fiscal year (FFY) 2023 and places limits on Medicaid uncompensated care (UCC) pools for non-expansion states. This policy watch explains what these payments are, what changes have been tied to the ACA, and examines potential implications of […]

  • Medicaid Policy Approaches to Facilitating Access to Vaccines for Low-Income Children

    Following the recent US Food & Drug Administration’s (FDA) authorization and the Centers for Disease Control and Prevention’s (CDC) recommendation, children ages 5-11 are now eligible to receive Pfizer-BioNTech’s COVID-19 vaccine. There may be unique challenges to vaccinating young children, particularly those from low-income families who may face additional barriers to access. State Medicaid programs […]

  • KHN’s ‘What the Health?’: Boosting Confusion

    Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. With covid caseloads rising across much of the country, several governors and mayors are unilaterally expanding access to booster shots, getting out ahead of federal health officials. […]

  • California Plans for a Post-Roe World as Abortion Access Shrinks Elsewhere

    SACRAMENTO — With access to abortion at stake across America, California is preparing to become the nation’s abortion provider. Democratic Gov. Gavin Newsom and legislative leaders have asked a group of reproductive health experts to propose policies to bolster the state’s abortion infrastructure and ready it for more patients. Lawmakers plan to begin debating the […]

  • Impact of drug coverage on mortality

    Clayton 2019 is an interesting study on the impact of drug spending on Medicaid beneficiary mortality levels. The author uses variation in the roll out of Medicaid drug coverage by state across different Medicaid eligible groups in order to isolate plausibly exogenous variation in drug expenditures. Using this approach, Clayton finds that: …a $1 increase […]

  • Missouri’s Thin Dental Safety Net Stretched Amid Medicaid Expansion

    At the Access Family Care clinics in southwestern Missouri, the next available nonemergency dental appointment is next summer. Northwest Health Services, headquartered in St. Joseph, is booked through May. The wait is a little shorter at CareSTL Health in St. Louis — around six weeks. Roughly 275,000 Missourians are newly eligible this year for Medicaid, […]

  • La inscripción de Medicare es temporada abierta para estafadores

    Encontrar el mejor plan médico privado, o de medicamentos, de Medicare entre docenas de opciones es lo suficientemente difícil sin incluir estrategias de venta engañosas. Sin embargo, funcionarios federales dicen que están aumentando las quejas de personas mayores engañadas para que compren pólizas sin su consentimiento, o atraídas por información cuestionable, que pueden no cubrir […]

  • How Could the Build Back Better Act Affect Uninsured Children?

    This brief examines characteristics of uninsured children in 2020 and discusses how current policy proposals, including outreach efforts, continuous eligibility requirements, and closing the coverage gap, could affect children’s health coverage. Recent efforts to expand coverage for adults could benefit children’s coverage, especially for children in non-expansion states if the coverage gap is filled as […]

  • Medicare’s Open Enrollment Is Open Season for Scammers

    Finding the best private Medicare drug or medical insurance plan among dozens of choices is tough enough without throwing misleading sales tactics into the mix. Yet federal officials say complaints are rising from seniors tricked into buying policies — without their consent or lured by questionable information — that may not cover their drugs or […]

  • HouseWorks Enters the Medicaid Personal Care Sector with Connected Home Care Acquisition

    HouseWorks announced Thursday that it has signed an agreement to acquire Connected Home Care, a home care provider that operates in Eastern Massachusetts. The Connected Home Care acquisition comes just one week after HouseWorks’ announced it purchased Atlantic Homelife Senior Care, a private home care provider that operates in Seacoast New Hampshire and Southern Maine. […]

  • Uninsured in South Would Win Big in Democrats’ Plan, but Hospitals Fear Funding Loss

    At least 2.2 million low-income adults — nearly all in Texas and the Southeast — would be eligible for government-funded health insurance under the Democrats’ $1.75 trillion social spending and climate change plan. That’s the number of people who are eligible for Medicaid under the Affordable Care Act but have been left uninsured because they […]

  • States Respond to COVID-19 Challenges but Also Take Advantage of New Opportunities to Address Long-Standing Issues: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2021 and 2022

    This report provides an in-depth examination of the changes taking place in Medicaid programs across the country. The findings are drawn from the 21st annual budget survey of Medicaid officials in all 50 states and the District of Columbia conducted by KFF and Health Management Associates (HMA), in collaboration with the National Association of Medicaid […]

  • Medicaid Enrollment & Spending Growth: FY 2021 & 2022

    This issue brief provides an overview of Medicaid spending and enrollment growth with a focus on state fiscal years 2021 and 2022. Findings are based on data provided by state Medicaid directors as part of the 21st annual survey of Medicaid directors in states and the District of Columbia conducted by KFF and Health Management […]

  • 50-State Medicaid Budget Survey Archives

    This page provides access to the reports stemming from the 50-state Medicaid budget surveys published annually since 2000 by the Kaiser Family Foundation (KFF). It tracks trends in Medicaid spending and enrollment, as well as Medicaid policy actions around eligibility and enrollment, provider rates, provider taxes/fees, premiums and cost-sharing, benefits and pharmacy, long-term care and […]

  • 3 States Limit Nursing Home Profits in Bid to Improve Care

    Nursing homes receive billions of taxpayers’ dollars every year to care for chronically ill frail elders, but until now, there was no guarantee that’s how the money would be spent. Massachusetts, New Jersey and New York are taking unprecedented steps to ensure they get what they pay for, after the devastating impact of covid-19 exposed […]

  • CMMI and its revised strategy

    Created by Section 3021 of the Affordable Care Act (ACA), the Centers for Medicare and Medicaid Innovation (CMMI; aka The CMS Innovation Center) has been tasked with creating new reimbursement strategies to improve quality and decrease costs. Over the past decade, CMMI has tested over 50 new payment models, and in just the last 3 […]

  • KHN’s ‘What the Health?’: Dems Agree to Agree, But Not on What to Agree On

    Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. Negotiations over what to include in — and cut from — the domestic spending package on Capitol Hill are reportedly making progress, but so far all Democrats […]

  • Watch: Going Beyond the Script of ‘Dopesick’ and America’s Real-Life Opioid Crisis

    KHN and policy colleagues at our parent organization KFF teamed up with Hulu for a discussion of America’s opioid crisis, following the Oct. 13 premiere of the online streaming service’s new series “Dopesick.” The discussion explored how the series’ writers worked with journalist Beth Macy, author of the book “Dopesick: Dealers, Doctors, and the Drug […]

  • 1 in 5 Adults Needs Ongoing Support for Activities of Daily Living

    Vice President Kamala Harris and Sen. Tammy Duckworth (D-Ill.) are the latest U.S. leaders to go to bat for home- and community-based services (HCBS), with the pair highlighting caregiving investments in the Biden administration’s Build Back Better plan during a Thursday town hall. Negotiations over Build Back Better, a package which includes multiple types of […]

  • Community Clinics Shouldered Much of the Vaccine Rollout. Many Haven’t Been Paid.

    Community clinics in California say they haven’t been paid for at least 1 million covid-19 vaccine doses given since January, creating a “massive cash flow problem” for some and complicating efforts to retain staff. Clinics in other states, including Michigan and Mississippi, are also awaiting payment. The delays stem from the distinct way federally qualified […]

  • In Focus Groups, Direct Care Workers and Unpaid Caregivers Describe Low-Wage, Physically-Challenging Work That is Often Mentally Overwhelming and Marked By Uncertainty

    In recent focus group interviews, 32 paid direct care workers and unpaid caregivers who assist seniors and people with disabilities with self-care and household activities describe daily work defined by low pay, physical demands and mental stress that has been made worse by the pandemic. KFF conducted the four focus groups in July and August…More

  • Voices of Paid and Family Caregivers for Medicaid Enrollees Receiving HCBS

    To help inform the ongoing debate, KFF conducted four focus groups in July and August 2021 with direct care workers and unpaid caregivers who provide HCBS, assisting seniors and people with disabilities with daily self-care and household activities. These focus groups are not necessarily generalizable to all caregivers, but can provide insight into their experiences […]

  • Analysis Examines Insurance Coverage, Affordability and Access to Home and Community-Based Services for Children with Special Health Care Needs

    A new KFF analysis examines key characteristics of children with special health care needs, the affordability and adequacy of their health coverage, and the implications for such children of potential new federal Medicaid money to assist families in caring for them. Medicaid is a significant source of coverage for medical, behavioral health, and long-term services…More

  • Children with Special Health Care Needs: Coverage, Affordability, and HCBS Access

    This issue brief provides context for ongoing policy discussions by describing key characteristics of children with special health care needs, comparing insurance affordability and access to key benefits among those covered by Medicaid/CHIP and those with private insurance, and considering the implications of additional Medicaid HCBS funding for children with special health care needs.

  • Mandatory Vaccines for Health Care Workers Might Upend Nurses’ Training

    Kaitlyn Hevner expects to complete a 15-month accelerated nursing program at the University of North Florida in Jacksonville in December. For her clinical training this fall, she’s working 12-hour shifts on weekends with medical-surgical patients at a hospital. But Hevner and nursing students like her who refuse to get vaccinated against covid-19 are in an […]

  • As Democrats Bicker Over Massive Spending Plan, Here’s What’s at Stake for Medicaid

    Hours after the Supreme Court in 2012 narrowly upheld the Affordable Care Act but rejected making Medicaid expansion mandatory for states, Obama administration officials laughed when asked whether that would pose a problem. In a White House briefing, top advisers to President Barack Obama told reporters states would be foolish to turn away billions in […]

  • Death in Dallas: One Family’s Experience in the Medicaid Gap

    For years, Millicent McKinnon of Dallas went without health insurance. She was one of roughly 1 million Texans who earn too much to qualify for Medicaid in the state but too little to buy their own insurance. That is, until she died in 2019. She was 64 and had been unable to find consistent care […]

  • ‘There’s a Lot of Unmet Need’: Addressing Long HCBS Waitlists

    Home- and community-based services (HCBS) are a way to fill gaps in care for seniors with complex medical conditions, with Medicaid being the main source of coverage for long-term services and supports (LTSS). As of 2020, over 2.5 million individuals received HCBS services, according to the Kaiser Family Foundation (KFF). Still, there are hundreds of […]

  • KHN’s ‘What the Health?’: The Autumn of Democrats’ Discontent

    Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. Democrats in Congress and the White House are feverishly negotiating to pass as much of President Joe Biden’s domestic agenda as they can agree on, even as […]

  • InnovAge CEO Maureen Hewitt: PACE Tailwinds Stronger Than Ever

    InnovAge (Nasdaq: INNV) went public earlier this year with a $350 million IPO. It has since set its sights on expansion. The largest Program of All-Inclusive Care for the Elderly (PACE) organization in the country, InnovAge is bullish on its ability to do just that, thanks to both internal confidence and also external, regulatory tailwinds. […]

  • Housing Affordability, Adequacy, and Access to the Internet in Homes of Medicaid Enrollees

    The COVID-19 pandemic and the ensuing economic disruption have drawn more attention to longstanding issues related to housing and internet access and how these issues can impact health. As the primary source of health insurance for low-income populations, Medicaid covers a considerable share of people living in homes that are unaffordable, inadequate, or have limited […]

  • California’s Reboot of Troubled Medi-Cal Puts Pressure on Health Plans

    When Denise Williams’ baby boy was 2 months old, she became alarmed by a rattling sound in his lungs and took him to the emergency room. While undergoing treatment, he spiraled into a disabling neurological disorder. Now 2 years old, Markeano is attached to breathing and feeding tubes. He can’t walk or move his arms. […]

  • Increasing LTSS Access Could Cost Up to $12.8 Billion Per Year

    Access to long-term services and supports (LTSS) in the U.S. remains limited, which currently puts seniors in need in a bind. Their options are often such: spend down on savings and assets in order to qualify for Medicaid, or rely on unpaid family care or other informal services. A new study from the Washington, D.C.-based […]

  • Dentists Chip Away at Uninsured Problem by Offering Patients Membership Plans

    Nevada dentist David White has seen diseased and rotted teeth in the mouths of patients who routinely put off checkups and avoided minor procedures such as fillings. While dental phobia is a factor, White said, the overriding reason people avoid treatment is cost. To help patients lacking dental insurance, White in 2019 started offering a […]

  • KHN’s ‘What the Health?’: Much Ado About Drug Prices

    Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. Congressional Democrats are finding it harder to actually write legislation to lower drug prices than it is to make promises about it. But the drug price provisions of the $3.5 trillion social-spending bill […]

  • No Papers, No Care: Disabled Migrants Seek Help Through Lawsuit, Activism

    Desperation led José Luis Hernández to ride atop a speeding train through northern Mexico with hopes of reaching the United States 13 years ago. But he didn’t make it. Slipping off a step above a train coupling, he slid under the steel wheels. In the aftermath, he lost his right arm and leg, and all […]

  • Implications of the Medicaid Fiscal Cliff for the U.S. Territories

    The U.S territories – American Samoa, the Commonwealth of the Northern Mariana Islands (CNMI), Guam, Puerto Rico, and the U.S. Virgin Islands (USVI) – have faced an array of longstanding fiscal and health challenges that were exacerbated by recent natural disasters and most recently by the COVID-19 pandemic. Differences in Medicaid financing, including a statutory […]

  • 38 States Have Increased HCBS Payments During the Pandemic

    To keep vulnerable Americans at home and out of riskier long-term care settings during the pandemic, the U.S. Centers for Medicare & Medicaid Services (CMS) gave states an unprecedented ability to temporarily modify their Medicaid home- and community-based services (HCBS) programs. But while the emergency waivers issued by CMS helped limit the spread of the […]

  • Health Care Unions Defending Newsom From Recall Will Want Single-Payer Payback

    SACRAMENTO, Calif. — Should Gavin Newsom survive the Republican-driven attempt to oust him from office, the Democratic governor will face the prospect of paying back supporters who coalesced behind him. And the leaders of California’s single-payer movement will want their due. Publicly, union leaders say they’re standing beside Newsom because he has displayed political courage […]

  • Georgia Eyes New Medicaid Contract. But How Is the State Managing Managed Care?

    Just before Frank Berry left his job as head of Georgia’s Medicaid agency this summer, he said the state “will be looking for the best bang for the buck” in its upcoming contract with private insurers to cover the state’s most vulnerable. But whether the state — and Medicaid patients — are getting an optimal […]

  • It’s Not Just Covid: Recall Candidates Represent Markedly Different Choices on Health Care

    SACRAMENTO, Calif. — Gov. Gavin Newsom’s covid-19 rules have been a lightning rod in California’s recall election. But there’s a lot more at stake for Californians’ health care than mask and vaccine mandates. Newsom, a first-term Democrat, argues that their fundamental ability to get health insurance and medical treatments is on the line. Republicans are […]

  • Colorado Clinic’s Prescription for Healthier Patients? Lawyers

    COMMERCE CITY, Colo. — In her 19 years of living with cerebral palsy, scoliosis and other ailments, Cynthia Enriquez De Santiago has endured about 60 surgeries and her heart has flatlined at least four times. But the most unusual doctor’s referral of her life came last year: Go see an attorney. Enriquez De Santiago sought […]

  • Akron Children’s, CareSource to launch ACO

    Dubbed the Akron Children’s Health Collaborative, the pediatric ACO will focus on improving care for the approximately 100,000 children in Ohio covered by Medicaid whose benefits are managed by CareSource.

  • CMS to fund 60 ACA navigator orgs next year

    CMS will provide $80 million to 60 organizations that train ACA navigators — who help consumers find coverage on the federally funded marketplaces — in the 2022 plan year, up from 30 organizations that received $10 million this year.

  • Beneficiarios de Medicaid se vacunan mucho menos contra covid

    Los beneficiarios de Medicaid se están vacunando contra covid-19 a tasas mucho más bajas que la población general, mientras los estados buscan las mejores estrategias para mejorar el acceso a las vacunas, y persuadir a quienes siguen indecisos. Los esfuerzos de las agencias estatales de Medicaid y los planes de salud privados que la mayoría […]

  • Headed Away to School? Here’s What Students With Health Issues Need to Know

    College is a time of transition, but for those managing chronic medical conditions, it may also be the first time they will be wholly responsible for their own health: setting appointments, securing supplies and pharmaceuticals, and monitoring symptoms. For those heading to schools far from home, it can be especially tricky navigating the complex world […]

  • Matthew’s health care tidbits

    Each week I’ve been adding a brief tidbits section to the THCB Reader, our weekly newsletter that summarizes the best of THCB that week (Sign up here!). Then I had the brainwave to add them to the blog. They’re short and usually not too sweet! –Matthew Holt For my health care tidbits this week, I […]

  • Biden’s No-Jab-No-Job Order Creates Quandary for Nursing Homes

    President Joe Biden’s edict that nursing homes must ensure their workers are vaccinated against covid-19 presents a challenge for an industry struggling to entice its lowest-paid workers to get shots without driving them to seek employment elsewhere. Although 83% of residents in the average nursing facility are vaccinated, only 61% of a home’s workers are […]

  • KHN’s ‘What the Health?’: Booster Time

    Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. As covid-19 cases in the U.S. continue to rise, the Biden administration is countering with new strategies. The latest efforts include preparing for vaccine boosters starting this […]

  • Cityblock Health & The ‘At-Risk’ Disruption of Medicaid Care

    By JESSICA DaMASSA, WTF HEALTH Innovation in Medicaid is HAPPENING – and not only is it capable of creating better, less expensive healthcare for Medicaid members, but Cityblock Health is proving that it can also be the underpinning of a business worth over $1B dollars. Dr. Toyin Ajayi, Cityblock’s co-founder & President, walks through the […]

  • KHN’s ‘What the Health?’: The Senate Acts

    Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. The Senate has set the stage for a busy fall that will include debate on a broad array of health issues, such as prescription drug prices, Medicare […]

  • Direct Care Workforce Shortages Have Worsened in Many States During the Pandemic, Hampering Providers of Home and Community-Based Services

    During the pandemic many states have experienced worsening direct care workforce shortages that have affected providers of home- and community-based long-term care services (HCBS), according to early findings of a new KFF survey of Medicaid HCBS programs in all 50 states and the District of Columbia. Most states reported workforce shortages as the pandemic’s primary…More

  • Medicaid Authorities and Options to Address Social Determinants of Health (SDOH)

    Extensive research and the pandemic have elevated the importance of addressing social determinants of health (SDOH) to improve health and reduce longstanding disparities in health and health care. Social determinants of health include factors like socioeconomic status, education, neighborhood and physical environment, employment, and social support networks, as well as access to health care. This […]

  • Feds to Nix Work Requirements in Montana Medicaid Expansion Program

    Federal health officials will likely reject Montana’s request to include work requirements for beneficiaries of its Medicaid expansion program, which insures 100,000 low-income Montana adults, state officials said. Three years after the Trump administration encouraged states to require proof that adult enrollees are working a certain number of hours or looking for work as a […]

  • COVID-19 Cases and Deaths in Long-Term Care Facilities through June 2021

    This data note examines state-level data on COVID-19 cases and deaths in long-term care facilities through June prior to the recent rise in cases and deaths nationally linked to the spread of the Delta variant. It finds long-term care deaths down 96% from their peak in December as the nation’s vaccination effort began.

  • KHN’s ‘What the Health?’: Hot Covid Summer

    Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. Predictions of a “hot vax summer” that would let Americans who had their covid immunizations celebrate the waning of the pandemic are turning out to have been […]

  • How a Doctor Breaks Norms to Treat Refugees and Recent Immigrants

    AURORA, Colo. — Fatumo Osman, a 65-year-old Somali refugee who speaks limited English, was in a bind. She made too much money at a meal prep service job so she no longer qualified for Medicaid. But knee pain kept her from working, so her income had dropped. She could reapply for Medicaid, get her knee […]

  • Elimination of the Medicaid asset test?

    No, this is not coming nation-wide, but it may be on its way in California. Kaiser Health News reports: A provision in California’s newly approved state budget will eliminate the asset test for the 2 million Californians enrolled in both Medi-Cal and Medicare, the federal health insurance program for people 65 and older and people […]

  • Despite Formidable Challenges, PACE Leaders Keep Expansion Dreams Alive

    The Program of All-Inclusive Care for the Elderly (PACE) concept has gained significant business and policy momentum over the past several months, with recent research also highlighting just how successful programs were at avoiding COVID-19 deaths compared to other care settings. Despite that traction and the model’s clear benefits, PACE still faces a long list […]

  • Analysis of Recent National Trends in Medicaid and CHIP Enrollment

    This data note looks at national and state-by-state Medicaid and CHIP enrollment data through February 2021, as states were still in the early stages of the COVID-19 vaccine rollout and were experiencing some economic improvements compared to earlier in the pandemic. After declines in enrollment from 2017 through 2019, total Medicaid/CHIP enrollment grew to 81.0 […]

  • How States Could Expand Medicaid HCBS Programs

    A large chunk of the home-based care industry and its workforce is focused on the Better Care Better Jobs Act, a recently introduced piece of legislation that would pump billions of dollars into care for the elderly. Medicaid-reimbursed in-home care providers haven’t forgotten about the increased federal matching rate — or “FMAP” — for home- […]

  • State Options to Expand Medicaid HCBS: Examples & Evaluations of Section 1115 Waivers

    States are currently developing plans to access an increased federal matching rate (“FMAP”) for Medicaid HCBS spending established in the American Rescue Plan Act (ARPA) of 2021. In the future, states may also be able to access increased HCBS funds proposed in the Biden Administration’s American Jobs Plan and the Better Care Better Jobs Act […]

  • Senate Democrats’ Plan Boosts Spending on Medicare, ACA Subsidies, Long-Term Care

    The budget package Democrats are assembling in Congress would likely provide the biggest jolt to the American health care system since the passage of the Affordable Care Act in 2010, according to sources familiar with work on the plan. Democrats in the Senate announced Tuesday night that they had reached a framework for a $3.5 […]

  • How do claim denials affect physician willingness to accept Medicaid patients?

    From a recent article in NBER by Dunn et al. (2021): Observing the back-and-forth sequences of claims’ denials and resubmissions for past visits, we can estimate physicians’ costs of haggling with insurers to collect payments. Combining these costs with the revenue never collected, we estimate that physicians lose 17% of Medicaid revenue to billing problems, […]

  • Transactions: Amedisys acquires VNA’s Home Health Assets; AccordCare Expands Medicaid Business

    Amedisys Inc. (Nasdaq: AMED) has completed its purchase of Visiting Nurse Association’s (VNA) assets. Baton Rouge, Louisiana-based Amedisys has a number of in-home care capabilities, including home health, hospice and personal care services. Amedisys also recently acquired Contessa Health for $250 million. The deal gives the company a range of acute-level care services. Meanwhile, VNA […]

  • ConcertoCare Adds Chief People Officer; CMS Appoints Medicaid Director

    ConcertoCare appoints chief people officer ConcertoCare has hired Rachel Grace as its chief people officer. Backed by Deerfield Management Company, the Aliso Viejo, California-based ConcertoCare offers in-home primary care, virtual care and PACE services to dual-eligible seniors and those enrolled under Medicare Advantage. In her new role, Grace will be responsible for developing hiring and […]

  • Cano Health buys Doctor’s Medical Center for $300M

    Senior-focused primary care provider Cano Health acquired Doctor’s Medical Center for $300 million, which adds around 54,000 new members and 18 medical centers to its roster. This is the second major acquisition for Cano Health in less than a month. The company bought University Health Care for $600 million in mid-June.

  • Job losses, federal regulations drove Medicaid enrollment to a historic high

    Enrollment in Medicaid and the Children’s Health Insurance Program has reached a record high, with 80 million now covered through these programs. The spike was largely driven by the economic downturn brought on by the pandemic and a federal requirement that prevents states from removing people from the programs until the public health crisis is […]

  • KHN’s ‘What the Health?’: Un-Trumping the ACA

    Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. The Biden administration this week proposed a series of changes aimed at boosting insurance enrollment under the Affordable Care Act, undoing changes made by the Trump administration […]

  • Desperate for Home Care, Seniors Often Wait Months With Workers in Short Supply

    CASTINE, Maine — For years, Louise Shackett has had trouble walking or standing for long periods, making it difficult for her to clean her house in southeastern Maine or do laundry. Shackett, 80, no longer drives, which makes it hard to get to the grocery store or doctor. Her low income, though, qualifies her for […]

  • CMS nixes Medicaid work requirements in Arizona, Indiana

    After scrapping work requirements for Medicaid eligibility in four states, CMS has added Arizona and Indiana to the list. These requirements have long been controversial, facing litigation and strong opposition, but proponents say they incentivize people to find jobs.

  • Pandemia eleva el número de beneficiarios de Medicaid a más de 80 millones

    Las últimas cifras de inscripción al Medicaid muestran que creció de 71,3 millones de miembros en febrero de 2020, cuando la pandemia comenzaba en los Estados Unidos, a 80,5 millones en enero, según un análisis de KFF de datos federales. La recesión causada por la pandemia y un requisito federal de que los estados mantuvieran […]

  • Pandemic Swells Medicaid Enrollment to Record 80 Million People

    The pandemic-caused recession and a federal requirement that states keep Medicaid beneficiaries enrolled until the national emergency ends swelled the pool of people in the program by more than 9 million over the past year, according to a report released Thursday. The latest figures show Medicaid enrollment grew from 71.3 million in February 2020, when […]

  • Analysis of Recent National Trends in Medicaid and CHIP Enrollment

    This data note looks at national and state-by-state Medicaid and CHIP enrollment data through January 2021, as states were still in the early stages of experiencing the health and economic effects of the coronavirus pandemic. After declines in enrollment from 2017 through 2019, preliminary data show that total enrollment grew to 80.5 million in January […]

  • GuideWell Announces Strategic Investment in Home-Based Primary Care Provider PopHealthCare

    Health plans — and the entities that own them — continue to invest heavily around in-home care. The latest example is GuideWell Mutual Holding Corporation, which announced a new “multi-year strategic investment” in subsidiary PopHealthCare on Wednesday. The company is not disclosing the exact size of the investment. “At GuideWell, we are committed to transforming […]

  • KHN’s ‘What the Health?’: Our 200th Episode!

    Can’t see the audio player? Click here to listen on SoundCloud. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts. The Food and Drug Administration found itself in the hot seat this week when it approved a controversial new drug to treat Alzheimer’s disease with scant evidence […]

  • Supplemental Security Income for People with Disabilities: Implications for Medicaid

    This issue brief describes key characteristics of SSI enrollees, explains the SSI eligibility criteria and eligibility determination process, and considers the implications of changes in the SSI program for Medicaid, including the effects of the COVID-19 pandemic and resulting economic downturn as well as proposals supported by President Biden that Congress might consider.

  • Expanding Insurance Coverage Is Top Priority for New Medicare-Medicaid Chief

    The new head of the federal agency that oversees health benefits for nearly 150 million Americans and $1 trillion in federal spending said in one of her first interviews that her top priorities will be broadening insurance coverage and ensuring health equity. Use Our Content It can be republished for free. “We’ve seen through the […]

  • Newsom Wants to Spend Millions on the Health of Low-Income Mothers and Their Babies

    Amid a pandemic that has pushed millions of mothers out of the workplace, caused fertility rates to plunge and heightened the risk of death for pregnant women, California Gov. Gavin Newsom and Democratic lawmakers are seeking a slate of health proposals for low-income families and children. Newsom, a self-described feminist and the father of four […]

  • Addus Focused on Sourcing New Home Health Acquisitions, Improving Applicant-Conversion Rates

    The COVID-19 public health emergency has solidified the home as a viable and effective care setting. That, in turn, has led to meaningful opportunities for home-based care providers, especially those with diversified service lines. Addus HomeCare Corporation (Nasdaq: ADUS) is a prime example. The company’s leadership team discussed the pandemic and its lasting impacts during […]

  • Caring for an Aging Nation

    USE OUR CONTENT This story can republished for free. Please contact [email protected] for embed codes. Table of Contents A Variety of Services Booming Number of Seniors The Cost of Long-Term Care Services The Physical – and Financial – Burden The $61 Billion Price Tag Health care for the nation’s seniors looms large as the baby-boom […]

  • Colorado Will Pay Hospitals to Close Expensive Free-Standing ERs

    Colorado health officials so abhor the high costs associated with free-standing emergency rooms they’re offering to pay hospitals to shut the facilities down. This story also ran on Fortune. It can be republished for free. The state wants hospitals to convert them to other purposes, such as providing primary care or mental health services. At […]

  • American Rescue Plan Funding Starts to Trickle Down to States, HCBS Programs

    American Rescue Plan (ARP) funding has started trickling down to programs aimed at helping seniors age in place. Earlier in May, the Biden administration released $1.4 billion for Older American Act-enabled initiatives related to vaccine coordination, senior nutrition and more. Meanwhile, the U.S. Department of the Treasury has been overseeing the distribution of $350 billion […]

  • KHN’s ‘What the Health?’: Roe v. Wade on the Ropes

    Can’t see the audio player? Click here to listen on SoundCloud. The Supreme Court agreed to hear a case next term that could result in a significant modification or overturn of Roe v. Wade, the 1973 case that legalized abortion nationwide. At issue is a Mississippi law that would ban the procedure after 15 weeks of […]

  • Why Your Dentist Might Seem Pushy

    In 1993, Dr. David Silber, a dentist now practicing in Plano, Texas, was fired from the first dental clinic he worked for. He’d been assigned to a patient another dentist had scheduled for a crown preparation — a metal or porcelain cap for a broken or decayed tooth. However, Silber found nothing wrong with the […]

  • The Pandemic Has Exacerbated Long-Standing Health Care Challenges Faced By Puerto Rico and Other U.S. Territories as the End of Temporary Federal Medicaid Funding Approaches

    A new KFF analysis examines how the coronavirus pandemic is affecting U.S. territories as well as issues related to the upcoming expiration of temporary Medicaid funding for the territories at the end of September. Prior to the pandemic, the U.S territories –– American Samoa, the Commonwealth of the Northern Mariana Islands (CNMI), Guam, Puerto Rico,…More

  • Challenges in the U.S. Territories: COVID-19 and the Medicaid Financing Cliff

    More than a year into the public health emergency, the COVID-19 pandemic continues to impact the lives of Americans including those living in the U.S. territories. Differences in Medicaid financing, including a statutory cap and match rate, have contributed to broader fiscal and health systems challenges for the territories. While additional federal funds have been […]

  • You’ve Added Your Kids to Your Health Plan. What About Mom?

    SACRAMENTO — When Laura Chavez’s 74-year-old mom needed eye surgery last month, Chavez paid cash for the procedure. This story also ran on Los Angeles Times. It can be republished for free. The cost? $15,000 — and that was for just one eye. She couldn’t afford both. Her mom, Esperanza Chavez, doesn’t qualify for Medicare […]

  • InnovAge CEO: ‘We Have a Couple of Irons in the Fire’

    Even though InnovAge (Nasdaq: INNV) is already one of the largest Program of All-Inclusive Care for Elderly (PACE) providers in the U.S., the company has plans to go after an even bigger piece of the pie. Maureen Hewitt, president and CEO of InnovAge, talked about the company’s multi-pronged growth strategy on Monday during a conference […]

  • This Mother’s Day, Let’s Get Mothers the Health Care Coverage They Need

    Mothers deserve more than a day of recognition this year—they deserve the whole month, and more. The pandemic has been particularly hard on women, especially poor women and women of color.  To demonstrate the appreciation mothers deserve this Mother’s Day, we should get them something they really need: health care. To improve maternal health, we should look […]

  • Medicaid Financing: The Basics

    Medicaid represents $1 out of every $6 spent on health care in the US and is the major source of financing for states to provide coverage to meet the health and long-term care needs of their low-income residents. This brief examines the following key Medicaid financing questions: How does Medicaid financing work?; How much does […]

  • Medicaid and State Financing: Key Indicators to Watch Through Pandemic and Recovery

    The health and economic effects of the pandemic have significant implications for state Medicaid programs. More people become eligible and enroll in Medicaid during economic downturns; at the same time, states may face declines in revenues. This brief presents the most current data for key indicators to help understand how various economic factors that could […]

  • 5 Things to Know About Health Care Changes in Montana

    HELENA, Mont. — The 2021 Montana legislative session will be remembered as one of the state’s most consequential as a Republican-led legislature and governor’s office passed new laws restricting abortions, lowering taxes and regulating marijuana. Use Our Content It can be republished for free. But the debate over those and other highly publicized issues may […]

  • New Analysis Summarizes Recent Research on the Effects of ACA Medicaid Expansion, Providing Context for Renewed Expansion Debates in States

    New federal financial incentives for Medicaid expansion and the increased reliance on Medicaid as a coverage safety net during the pandemic have renewed debate in the 12 states that have not adopted the Medicaid expansion under the Affordable Care Act. A new KFF literature review provides context for these expansion debates by summarizing evidence from…More

  • Potential Implications of Policy Changes in Medicaid Drug Purchasing

    This brief examines how leading federal and state policy options related to changes in Medicaid Drug Rebate Program (MDRP), drug pricing, and payment and management of the Medicaid prescription drug would affect state and federal governments as well as private industry (including drug manufacturers, managed care organizations, and pharmacies).

  • Covered California Says Health Insurance Just Got Too Cheap to Ignore

    If you are uninsured because health coverage seemed too expensive the last time you looked, it’s time to look again. Use Our Content It can be republished for free. A new federal law could make it a whole lot cheaper to buy your own insurance if you don’t get coverage through an employer or a […]

  • Medicaid Postpartum Coverage Extension Tracker

    This page tracks recent state actions to extend Medicaid postpartum coverage, including approved and pending 1115 waivers, legislation that will require the state to seek federal approval through a SPA or 1115 waiver, submitted and approved SPAs, and coverage financed solely with state funds.

  • Health Insurer Financial Performance in 2020

    This analysis examines insurers’ financial data across markets through the end of 2020. It finds that average margins remained relatively high compared to recent years, suggesting many insurers remained profitable even as health spending rebounded and COVID-19 cases surged in the fall and winter.

  • In Speech to Congress, President Biden Again Shines Spotlight on Home-Based Care

    In a speech delivered to Congress Wednesday, President Joe Biden again mentioned the importance of providing care to seniors in their own homes. Specifically, he touted his administration’s previously announced American Jobs Plan, which would include $400 billion for home-based care. Much of that money would go to the workforce, with home health and home […]

  • KHN’s ‘What the Health?’: 100 Days of Health Policy

    Can’t see the audio player? Click here to listen on SoundCloud. It’s been a busy 100 days for the Biden administration on health policy. The promise Joe Biden made as president-elect to get 100 million covid vaccinations in arms was doubled, reopened to those without insurance, and steps were taken to undo a raft of […]

  • Votive Health Raises $2.5M to Help Home-Based Care Providers Make Value-Based Arrangements

    Votive Health — a technology startup that facilitates payer-provider integration — formally announced its launch and first funding round on Wednesday. The company raked in $2.5 million in a round led by Flare Capital Partners, with Chrysalis Ventures and OCA Ventures as co-investors. San Luis Obispo, California-based Votive Health is a technology-enabled network manager that […]

  • KHN’s ‘What the Health?’: Picking Up the Pace of Undoing Trump Policies

    Can’t see the audio player? Click here to listen on SoundCloud. The Biden administration is speeding up the pace of efforts to undo Trump administration health policies. The two most recent: overturning a ban on fetal tissue research funded by the National Institutes of Health and canceling a last-minute extension of a Medicaid waiver for Texas. […]

  • Filling the Coverage Gap: Policy Options and Considerations

    This issue brief examines some of the other options policymakers may consider to extend coverage to people in the gap, including increased fiscal incentives for states, a narrower public option, and making people with incomes below the poverty level eligible for enhanced ACA premium subsidies.

  • Why Minnesota’s Largest Home Care Provider Doubled Down on Financial Management Services

    In the crowded home-based care market, providers have been forced to become increasingly more creative when it comes to their service offerings. One company, Accra, recently saw success with the growth of its unique financial management services program. The Minnetonka-based Accra is the largest provider of home care services in Minnesota. Among its offerings, the […]

  • Strides Against HIV/AIDS Falter, Especially in the South, as Nation Battles Covid

    Facing a yearlong siege from the coronavirus, the defenses in another, older war are faltering. This story also ran on NPR. It can be republished for free. For the last two decades, HIV/AIDS has been held at bay by potent antiviral drugs, aggressive testing and inventive public education campaigns. But the COVID-19 pandemic has caused […]

  • KHN’s ‘What the Health?’: Pause and Effect on Covid Vaccines

    Can’t see the audio player? Click here to listen on SoundCloud. The effort to vaccinate Americans against covid-19 took a hit this week. The Centers for Disease Control and Prevention and the Food and Drug Administration jointly called for a pause in use of the vaccine made by Johnson & Johnson while experts try to figure […]

  • Biden, Congress Extend Medicare Sequestration Holiday Through 2021

    The long and winding saga behind the Medicare sequestration holiday for home health providers and others has come to a close. On Tuesday, the U.S. House of Representatives overwhelmingly voted by a 384-38 margin in favor of a continued sequestration delay. The legislation was one of two measures introduced since early March aimed at delaying […]

  • What Will It Take for Hospitals to Survive the Pandemic?

    Dr. John Frownfelter, MD, FACP, Chief Medical Officer at Jvion In 1852, Mercy Hospital & Medical Center opened as Chicago’s first chartered hospital. In May, it will close, leaving residents of the surrounding South Side community — poor and mostly people of color — without a place to see a doctor. And it isn’t the […]

  • Biden Seeks $400 Billion to Buttress Long-Term Care. A Look at What’s at Stake.

    There’s widespread agreement that it’s important to help older adults and people with disabilities remain independent as long as possible. But are we prepared to do what’s necessary, as a nation, to make this possible? This story also ran on NPR. It can be republished for free. That’s the challenge President Joe Biden has put […]

  • Time and Goals Should Drive Your Post-COVID-19 Care Management Strategy

    Jessica Scruton, BSN, RN, CCM, VP of Clinical Transformation for Lightbeam Health Solutions COVID-19 forced many health systems to reassess and reconfigure their care management processes and staffing models so that clinicians could better manage more of their acute, complex, and otherwise healthy patients remotely to limit in-person care.  During this time, health systems likely […]

  • KHN’s ‘What the Health?’: Health Care as Infrastructure

    Can’t see the audio player? Click here to listen on SoundCloud. Health care makes some surprising appearances in President Joe Biden’s $2 trillion infrastructure plan, even though more health proposals are expected in a second proposal later this month. The bill that would help rebuild roads, bridges and broadband capabilities also includes $400 billion to help […]

  • Analysis of Recent National Trends in Medicaid and CHIP Enrollment

    This data note looks at national and state-by-state Medicaid and CHIP enrollment data through November 2020, as states were still in the early stages of experiencing the health and economic effects of the coronavirus pandemic. After declines in enrollment from 2017 through 2019, preliminary data show that total enrollment grew to 78.9 million in November, […]

  • Families With Sick Kids on Medicaid Seek Easier Access to Out-of-State Hospitals

    Three-year-old Elizabeth Zakutansky was born with a rare genetic condition that causes multiple seizures. Her neurologist, a top expert on treating her condition, practices at Lurie Children’s Hospital of Chicago, less than an hour’s drive from the Zakutanskys’ home in Hobart, Indiana. Her parents would like her to get all her care there. This story […]

  • KHN’s ‘What the Health?’: Planning for Round Two

    Can’t see the audio player? Click here to listen on SoundCloud. Congress is out of session, but that hasn’t stopped Democrats from planning their next round of health legislation. Together with President Joe Biden, they are looking at a broad array of possibilities, from allowing Medicare to negotiate drug prices to adding more benefits to the […]

  • Boost Operational, Clinical and Financial Performance with Good Data

    Peter Nelson, VP & General Manager, Global Alliances at GHX There’s an old adage that every challenge is merely an opportunity in disguise. COVID-19 highlighted the healthcare industry’s ongoing challenge with producing clean, standardized data. As the industry looks to rebound from the severe financial impact of the pandemic, there’s a renewed urgency among hospitals […]

  • Indiana’s Medicaid Expansion — Designed by Pence and Verma — Panned in Federal Report

    Indiana’s Medicaid expansion — with its “personal responsibility” provisions that require enrollees to pay monthly premiums and manage health savings accounts — proved no better at improving health and access to care than other state expansions, a federally commissioned study found. Use Our Content It can be republished for free. Even when compared with states […]

  • The Great Undoing: Which of Trump’s Policies Will Biden Reverse?

    KHN has put together an interactive tool of significant health policies implemented by the Trump administration using its own authority — executive orders, agency guidance or formal regulations — and is tracking Biden administration and court actions. We will update this chart as actions are taken. Topics: Affordable Care Act | HHS Operations | Immigration […]

  • How the Pandemic is Accelerating the Shift to Alternative Care Delivery Models

    Mark Prather MD, MBA, CEO & Co-founder at DispatchHealth The COVID-19 pandemic has transformed how we interact with one another, with businesses, and with the world around us. From social distancing to hand sanitation to remote working, its impact on society is immense. And among the various industries that are experiencing significant change as a […]

  • Democrats Gave Americans a Big Boost Buying Health Insurance. It Didn’t Come Cheap.

    When Democrats pushed through a two-year expansion of the Affordable Care Act in the covid-relief bill this month, many people celebrated the part that will make health insurance more affordable for more Americans. This story also ran on NPR. It can be republished for free. But health care researchers consider this move a short-term fix […]

  • KHN’s ‘What the Health?’: ACA Packs More Benefits — And More Confusion

    Can’t see the audio player? Click here to listen on SoundCloud. The covid relief bill signed by President Joe Biden a week ago includes billions of dollars in new health benefits for consumers. But those benefits may be hard for people to take advantage of because of the interaction with the income tax system and the […]

  • Unite Us Nabs $150M, Reaching $1.6B Valuation to Address Social Determinants of Health

    What You Should Know: –   Unite Us, the tech company creating coordinated care networks nationwide, has just announced a $150M Series C round of funding led by ICONIQ Capital, bringing its valuation at $1.65 billion.   – Unite Us is leading the care transformation movement towards whole-person health with its core product, Unite Us Platform, an outcome-focused coordination software sconnecting community-based […]

  • Analysis: The Trump Health Care Policies That Deserve to Stick Around

    President Joe Biden’s goal of providing health care for more Americans advanced this week with his signing of an economic stimulus package that includes subsidies for health insurance premiums and new incentives for states to expand Medicaid, as well as the potential confirmation of Xavier Becerra as secretary of Health and Human Services. This story […]

  • Quality Virtual Care Matters for Patients – Even More Than Telehealth

    Rick Halton, Vice President of Marketing, Lumeon The COVID-19 pandemic made healthcare visits over video or phone the norm, likely turning telehealth into a permanent fixture within the U.S. healthcare system. In fact, the majority of patient access leaders at large hospitals believe 20-30 percent of appointments will happen over video in 2021, according to […]

  • PE-Backed Help at Home Names New CEO

    Help at Home has a new CEO. The home- and community-based services provider announced Monday that current board member Chris Hocevar has been appointed chief executive officer, effective immediately. Hocevar replaces Paul Mastrapa, who previously served as a consultant and as the leader of Option Care before taking over as Help at Home’s CEO in […]

  • A Look at How Medicaid Agencies Are Assisting with the COVID-19 Vaccine Roll-Out

    As of February 2021, there are three COVID-19 vaccines approved for emergency use in the U.S. and states are playing a central role in their timely distribution and prioritizing eligible populations. Because Medicaid covers for over 77 million enrollees, including groups disproportionately at risk of contracting COVID-19 as well as hard-to-reach groups, Medicaid agencies can […]

  • KHN’s ‘What the Health?’: Expanding the ACA in an Unpredicted Way

    Can’t see the audio player? Click here to listen on SoundCloud. For the first time since its enactment in 2010, the Affordable Care Act is slated for major benefit expansions, courtesy of the covid relief bill approved by Congress this week. But the changes are only temporary, so the measure also tees up a fight to […]

  • Addus Enters Value-Based Care Deal with Presbyterian Health Plan

    Addus HomeCare Corporation (Nasdaq: ADUS) — the personal care services powerhouse that has increasingly turned its attention to home health and hospice care over the past few years — has inked a new value-based care deal. The Frisco, Texas-based in-home care company announced Wednesday that it has entered into a “value-based post-acute care navigation agreement” […]

  • KFF Tracking Poll: More Than a Third of Americans Say They’ve Struggled to Pay Living Expenses Since December; 6 in 10 Families Hit by COVID Have Lost A Job or Income

    Majorities Favor Provisions to Expand Marketplace Tax Credits and Encourage States to Expand Medicaid As Congress considers an additional $1.9 trillion COVID-19 relief plan, more than a third (37%) of Americans say that someone in their household has had trouble paying basic living expenses over the past three months, the latest KFF Health Tracking Poll…More

  • KFF Health Tracking Poll: Economic Hardship, Health Coverage, And The ACA

    This poll examines the public’s assessments of the Biden administration’s handling of the coronavirus pandemic, the impact COVID-19 has had on people’s finances, and support for provisions of the latest COVID-19 relief bill. It examines the public’s views of the ACA and possible next steps.

  • Many Nonelderly People With Disabilities Face COVID-19 Risks Similar to Those of the Elderly in Nursing Homes, But Do Not Have Equal Footing When it Comes to Vaccine Priority

    While the toll of COVID-19 on nursing home residents has been well documented, less noticed has been the experience of nonelderly people with disabilities who rely on long-term care services and supports outside of nursing homes. In many ways the two groups face similar health risks from the virus, but nonelderly people with disabilities generally…More

  • COVID-19 Vaccine Access for People with Disabilities

    This issue brief presents current state-level data about COVID-19 cases and deaths in settings that primarily serve nonelderly people with disabilities and summarizes available research on this population’s elevated risk of severe illness and death; explains how nonelderly people with disabilities and their LTSS providers are reflected in state vaccine prioritization plans; and discusses key […]

  • State Variation in Medicaid LTSS Policy Choices and Implications for Upcoming Policy Debates

    This brief takes a closer look at multiple measures beyond waiver waiting lists to evaluate state choices about optional Medicaid eligibility pathways, spending, and services for seniors and people with disabilities as of 2018. The analysis draws on several KFF resources, including 50-state surveys of Medicaid financial eligibility pathways for seniors and people with disabilities, […]

  • With GOP Back at Helm, Montana Renews Push to Sniff Out Welfare Fraud

    Montana is considering becoming the latest state to intensify its hunt for welfare overpayments and fraud, a move expected to remove more than 1,500 enrollees from low-income health coverage at a time when the pandemic has left more people needing help. With Republicans now controlling both chambers of the Montana legislature and the governor’s office, […]

  • 3 Ways to Boost Patient Confidence with Real-Time Contactless Communication

    Ford Blakely, SVP & GM, Medallia Zingle Although the vaccine’s rollout is slowly underway, Covid cases worldwide are continuing to reach all-time highs as new mutations make the virus even more contagious than ever before. Not surprisingly, patients’ concerns about visiting their healthcare providers in the midst of this global pandemic persist, pushing demand for […]

  • KHN’s ‘What the Health?’: Open Enrollment, One More Time

    Can’t see the audio player? Click here to listen on SoundCloud. An estimated 9 million Americans eligible for free or reduced premium health insurance under the Affordable Care Act have a second chance to sign up for 2021 coverage, since the Biden administration reopened enrollment on and states that run their own marketplaces followed suit. […]

  • Two New Analyses: House COVID-19 Relief Plan Would Temporarily Lower Marketplace Premiums for Millions and More than Offset Short-Term State Costs to Expand Their Medicaid Programs

    The House COVID-19 relief proposal would temporarily lower what millions of Marketplace enrollees and uninsured potential enrollees would pay toward premiums and would provide states that have not expanded their Medicaid programs a financial boost that would more than offset their costs initially, two new KFF analyses find. The analyses assess two parts of the…More

  • Arizona to Implement a Statewide Social Determinants of Health Closed Loop Referral System

    What You Should Know: – Health Current, Arizona’s health information exchange (HIE), today announced the selection of NowPow as the vendor of choice for Arizona’s closed-loop referral system (CLRS) to address social determinants of health (SDOH) needs in Arizona. – By connecting healthcare and community service providers on a single statewide technology platform, this new […]

  • Why Biden Has a Chance to Cut Deals With Red State Holdouts on Medicaid

    President Joe Biden has an unexpected opening to cut deals with red states to expand Medicaid, raising the prospect that the new administration could extend health protections to millions of uninsured Americans and reach a goal that has eluded Democrats for a decade. The opportunity emerges as the covid-19 pandemic saps state budgets and strains […]

  • KHN’s ‘What the Health?’: All About Budget Reconciliation

    Can’t see the audio player? Click here to listen on SoundCloud. President Joe Biden has said he still wants a bipartisan bill to provide the next round of covid relief. But in case that doesn’t happen, House committees this week got down to work on a budget reconciliation bill that could pass the Senate with a […]